Purpose: To examine the spectrum of scleritis in four tertiary institutions across the Asia-Pacific. Methods: Clinical records from 354 patients were reviewed from centers in Australia, Singapore, and India, excluding those with insufficient data (n = 24). Results: Indian patients presented younger (41.5 ± 13.4 years) than Australians (50.8 ± 17.5) and Singaporeans (48.6 ± 15.9), with fewer women (49% vs 62%/57%). Diffuse disease was universally most common. Autoimmune and infectious disease proportions were similar in Australia (31%/10.3%) and Singapore (27.5%/8.3%) but reversed in India (8.3%/30%). Necrotizing scleritis was most frequently associated with infection (27.3%). Presumed ocular tuberculosis accounted for 75% of infectious cases in India. Posterior scleritis had the highest complication rate (82.4%) and immunosuppressants used per patient (0.98 ± 0.31 95% CI). Conclusions: Clinical presentations of scleritis vary across the Asia-Pacific, particularly in endemic regions for tuberculosis such as India, where it affects younger men with a predominance of nodular and infectious disease.
Keywords: Asia-Pacific; autoimmune scleritis; diffuse anterior scleritis; infective scleritis; necrotizing anterior scleritis; nodular anterior scleritis; posterior scleritis; scleritis.